使用炎症和代谢生物标志物的风险分层:对动脉样硬化心血管疾病死亡率的多队列预测研究
Xiao Li1, Qingyue Zeng2, Xiaoyu Zhang3
1Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Key Laboratory of Internal Medicine of Chinese Medicine, Ministry of Education, Beijing University of Chinese Medicine, Beijing, China.
Life sciences
|January 6, 2026
概括
压力高血糖比率 (SHR) 和中性粒细胞与淋巴细胞比率 (NLR) 的结合显著改善了动脉样硬化心血管疾病 (ASCVD) 患者的全因死亡率预测. 这种双生物标志物方法比单个标志物提供了优越的预后分层.
科学领域:
- 心血管医学 心血管医学
- 生物标志物研究 生物标志物研究
- 预测研究 预测研究
背景情况:
- 动脉样性心血管疾病 (ASCVD) 的发病包括复杂的代谢和炎症相互作用.
- 压力高血糖比率 (SHR) 和中性粒细胞与淋巴细胞比率 (NLR) 分别是代谢压力和炎症的生物标志物.
- 之前的研究表明,SHR和NLR在ASCVD的预后价值.
研究的目的:
- 研究SHR和NLR在ASCVD患者全因死亡率的综合预测作用.
- 评估这种风险分层的双生物标志物方法的临床适用性.
主要方法:
- 来自MIMIC-IV和NHANES数据库的ASCVD患者的回顾性分析.
- 基于SHR和NLR三位体的患者分层.
- 利用多变量考克斯回归,受限立方线,时间依赖的ROC分析和机器学习模型来评估死亡率关联.
主要成果:
- 增加的SHR和NLR独立地与NHANES和MIMIC-IV队列中的全因死亡率增加有关.
- 高SHR和NLR的组合显示出最明显的死亡风险,危险比率明显高于单个标志物.
- 综合的SHR-NLR评估显著提高了ASCVD患者死亡率的预测准确度.
结论:
- 综合的SHR-NLR评估有效量化了ASCVD中结合的代谢-炎症损伤.
- 这种双生物标志物方法为ASCVD患者提供了优越的预后分层,与个人生物标志物评估相比.
- 建议进一步进行前性验证,以确定综合SHR-NLR方法在不同人群中的临床效用.
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